Indian Health Service to upgrade its EHR system

The Indian Health Service (IHS) plans several upgrades to its electronic health record (EHR) system this year, including changes to conform to new federal regulations for "meaningful use," national information exchange and public health, according to a new report from IHS’ Office of Information Technology.

IHS’ record system, named the Resource and Patient Management System (RPMS), will be certified as an inpatient system that complies with new Health and Human Services Department regulations published Jan. 13 for meaningful use of EHRS, the Office of IT Annual Stakeholder Report 2009 states. “Meaningful use” refers to use of record systems that are capable of collecting and sharing clinical data to support better quality of outcomes and public health.

Plans for 2010 include “initial certification of RPMS as an inpatient electronic health record system that complies with meaningful use requirements,” the report, published Feb. 10, said. The system also will be recertified as an ambulatory care record system.

“Practice Management applications will make required changes to software to address federally mandated meaningful use objectives and quality measures,” the report said. “Applications will be modernized, and immediate needs will be addressed using [stimulus law] funds.”

Work on supporting requirements for health data exchange, including exchange in HHS’ Nationwide Health Information Network, as well as to support a Master Person Index, will begin in mid-to-late fiscal 2010 and into fiscal 2011, the report said.

“An Office of IT goal is to have numerous new federal staff and contractors on board to optimize the implementation of the RPMS Electronic Health Record,” the report stated.

The optimization will include adoption of a dashboard to improve patient flow management in emergency departments, urgent care and other clinical settings.

The IHS also is developing Care Management Event Tracking capabilities in RPMS to track scheduled diagnostic tests and events such as mammograms and pap smears and to ensure follow-up in the event of abnormal results.

The RPMS is a government-owned and -developed system that uses about 57 percent of the resources of the Office of IT.

It includes a repository of historical medical information, documentation of care, medication management, order entry and results reporting, and third-party billing. RPMS is used in about 200 IHS facilities that provide health care services.

In 2009, Office of IT staff members focused on software development for the RPMS, funded by money from the economic stimulus law. One of the new applications is the Contract Health Service Management Information system, which is interfaced with the IHS’ financial systems and its departmental contract system. Another is iCare 2.0, which is an application of community alerts deployed nationally in 2009.

In addition, the service facilitated use of RPMS for behavior health care services and H1N1 influenza surveillance and achieved a security accreditation for three years.

Other top priorities of the IHS Office of IT in 2009 included telemedicine coordination, data quality, infrastructure and a decision support system.